Sampaio Filipa, Langegård Ulrica, de Alva Patricio Martínez, Flores Sergio, Nystrand Camilla, Fransson Per, Ohlsson-Nevo Emma, Kristensen Ingrid, Sjövall Katarina, Feldman Inna, Ahlberg Karin
Department of Public Health and Caring Sciences (IFV), Uppsala University, BMC, Husargatan 3, Uppsala, 751 22, Sweden.
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Cost Eff Resour Alloc. 2024 Sep 13;22(1):66. doi: 10.1186/s12962-024-00577-6.
This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden.
Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs.
PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914-7,659) over a 58 weeks' time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195-0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay.
These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT.
Not applicable.
本研究评估了在瑞典，质子束治疗（PBT）与传统放射治疗（CRT）相比，治疗脑肿瘤患者的成本效益。
使用了2015年至2020年期间进行的一项纵向非随机研究的数据，其中包括成年脑肿瘤患者，在治疗期间及之后进行了为期一年的随访。临床和人口统计学数据来自纵向研究，并与瑞典国家登记处相关联，以获取医疗资源使用信息。采用成本效用框架评估PBT与CRT的成本效益。使用倾向得分匹配替换法，根据相关可观察指标将PBT组（n = 310）的患者与CRT组（n = 40）的患者进行匹配。从医疗保健角度估算成本，包括与住院和专科门诊护理以及处方药相关的成本。健康结果为质量调整生命年（QALY），源自欧洲癌症研究与治疗组织生活质量核心问卷（EORTC-QLQ-C30）。使用广义线性模型（GLM）和两部分模型估算成本和QALY的差异。
在58周的时间范围内，PBT的总成本为14,639美元，高于CRT的13,308美元，相差1,372美元（95%置信区间，-4,914至7,659）。此外，PBT导致的QALY略低于CRT，分别为0.746和0.774，相差-0.049（95%置信区间，-0.195至0.097）。在任何支付意愿下，PBT具有成本效益的概率均<30%。
这些结果表明，与CRT相比，PBT不能被视为治疗脑肿瘤的具有成本效益的治疗方法。
不适用。
